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HomeMy WebLinkAbout2526 Tucker Ct - Applications/Water Heater - 02/21/2018�Ci;.y Of o 'Fort Co uns Plannincul Development; & Transpad9doa 28: N. College Ave P.O. Box 580 Fort Collins, CO 80524 Phone 970= trio'-2740 Fax 224613A This application is to be used to apply for the lolloWing permits only (check all that apply), 0 Air Condrdorimg 0 Demolition (interior non-structural) 0 'Electrical Alteration (not sondes change) D Gas tighter 0 Gas Log 0 Heating Unit 0 Lawn Sprinkler 0 Mobile Home replacement n Roofing Q Sewer Line - 0 Photo -voltaic ❑ Ventilation XWater Heatar 0 Waler Line n Wood/Pellet Stove (must be EPA certified, pmvlde make, model and manufacturer). Complete all applicable information i a'tiion on thhe; applioedon. Incomplete applications will not be accepted. Appl[Catioii -YS V I�V r�ata i_ . 2e • Q� Forofte L� only Job 51t-s Address ftgdmd) VElUe of Co7biruCtlon (labor, matrxiais, profit) 2 << G F L 3052.(D 5 00 Property Owner Name Address City/SmItt: - Phone ' QZIP . Applicant Same Address mylstate Zip Phone „n u 13� c -& efef Conuraeeor Address tylState Zip Phone La Ail Contra ctor City of Ft Collins S Ta rrt P- / Are you paying ta:.es here or by report? ❑ Here gR�port Satan ws n_m-xts requved byaVcaneavis Ir00-7q i Are you paying llgdl your trust account? j�Yes 0Alo is this a residential or co martial pmjea? i9( Residential n Commercial =f resider Single Fayi, ❑ Condojtownhome (single family attached) - • Cl Duple 0 MulMailly (apartment) 0 Garage 'sf commercial, is iu 0 Bank 0 Bar 0 Church 0 Hotel/Motel 0 Medical office 13 obits Q Rail © Restaurant 0 Other (explain) is this building 50 years of age or more? ❑ Yes C No ryes, you mayneed to mn4aCr1ffM0r1cPYa5&Vap'0R ref this is for a demolition permmt, what year was the building constructed? =fprior 10 275, ,vOu will napd an asilesios asses smirk to submit web ft appffcatfon. Description of ,%0 k Lin O A TIF lawn sprinkler/badt@ow pemter, must 115E licensed plumber. :iF first fine k(1, must fish licensed aleM&n.. Subcontractor=_! L!St iha cocrpanynarneorOZvofFcCollinshlceose Eiectridan Plumber Mzchanicaf Rgarer. Oli]ec I hereby acknawledge that I have read ft application and st ats that the above information is complete and correct, I agree to Comply YAM all requirements contained herein and City ordinances.and State laws regulating building construction. "a know that a permit is not valid until It has Been paid and issued. Applicant„ Print Name: Signature S��a�E t • 1 b